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More Life to Be Lived

Cancer can wear you down until you remember life’s pleasures.Credit Christian Hartmann/Reuters

Occasionally I feel so worn down by the exigencies of cancer and of aging that I believe the time has arrived to face the end, though I dearly wish to be proven wrong.

Upon awakening after the first night at the new apartment, nausea overwhelmed me. The boxes had propagated. In every room, cartons of books, dishes, cutlery, glasses, cookware, clothing, cleaning implements, medical equipment, towels, sheets, quilts, photos, and paintings lined the walls.

Did hauling around some of these parcels produce the extensive bruising on my upper arms? I would not know for sure until a few days later, when I was scheduled to see my oncologist. What, if anything, would I do, if her explanation sounded more sinister? Would I be as proactive as I had been in the past? Or had multiple procedures, along with the passage of time, combined to diminish my inner resources?

To medical professionals and acquaintances who ask, I never say, “I had cancer.” The past tense sounds fraudulent. While powerful medication keeps my disease from roaring back, I consider myself a patient depleted but not yet unhinged by ongoing treatment. Like me, other people with chronic conditions may find their resolve and their objectives altering as they grow older and frailer.

In the meanwhile, there were urgent issues to take my mind off my qualms. The dishwasher and entry lights did not work, and where were the bulbs for the lamps?

Since my husband, Don, and I were getting sick of the available fast food, I set to work on the kitchen, while worrying that the purplish-blue splotches on my arms had been caused by required interruptions of my medication. For reasons beyond my control, my second cataract surgery had been scheduled a few days before the relocation.

Before, during and after each eye operation, the experimental drug I take in a clinical trial had to be discontinued. Various medical advisors had assured me that a brief cessation of the pills would not reactivate the cancer. Still, maybe the dosage breaks had endangered me, I thought as I noted darkening spots on my thighs and calves as well.

But bruises do not compute with ovarian cancer, which causes abdominal discomfort and bloating. Skin discoloration, along with bone and joint pain, would point in the direction of leukemia. I brooded over this possibility. My previous oncologist had explained that the trial’s drug, a PARP inhibitor, blocked the ability of cancer cells to repair themselves. Fiddling with my DNA, it might produce a secondary cancer, possibly one of the blood.

As Don and I decided where to put the pots and mixing bowls, my fatigue and aches got the better of me, and I began to dread that leukemia would do me in. Unable to find a flatware drawer or, for that matter, flatware, I put plastic forks on a counter and then dragged empty boxes into the garage while imagining myself declining further medical protocols. Weren’t eight years of living with cancer enough? I pictured myself in a hospital bed near the living room window overlooking a leafy tree.

That my mind would so quickly posit a still-fictive diagnosis of leukemia was not that surprising. When Don and I had first viewed the apartment, I had asked him, “Can you visualize yourself living here alone?” Neither of us could negotiate the capacious country house we had inhabited for decades. Nor could we imagine surviving widowed within it. “Yes,” he had said. There and then, we decided to sell a beautiful place full of cherished memories. “At least we are leaving together,” we kept on reassuring ourselves.

Too tired to continue unpacking, dependent on friends to empty wardrobe cartons and to take the cardboard to the recycling center, I found myself realizing that we have different aims as cancer patients at different stages of our lives.

In my early 60s, I was willing to undergo the miseries of surgeries, lymphedema, infections, massive infusions of antibiotics, a succession of drainage tubes implanted by radiologists, the toxicity of numerous chemotherapies, neuropathies, and an ileostomy as well as weight and hair loss. Worn down in my early 70s, I feel more wary about arduous interventions, about their psychological, physical and financial costs. Also, aren’t there plenty of younger people whose health needs should take precedence over mine?

Treatment goals shift over time as our performance status — the measure of how well we can carry on everyday activities — declines. It strikes me that cancer patients recurrently have to evaluate our condition in order to reassess our aspirations and priorities.

At the meeting with my oncologist in Indianapolis a few days later, she checked the results of my blood tests on the computer, listened to my breathing, and poked my neck, ankles and stomach. “I pronounce you leukemia-free,” my doctor declared with a grin.

She then confided that some years ago bruises had triggered her own worries about leukemia, which were only put to rest when her physician-husband asked if she had started taking aspirin. Oncologists, apparently, share with their patients the free-floating anxiety spawned by cancer.

After a long drive through highway construction, Don and I returned home to find that a neighbor had taken advantage of an electrician inside our apartment to put two small containers of ice cream in the freezer. I ate mine with a plastic fork and, as it melted, I lapped it up like a cat.